Formal Complaint Form… Name(Required) First Last Email(Required) Phone(Required)Please include below a detailed summary of all of the specific incidents or examples of behavior that have led to the filing of the complaint, including the following: The dates and times of each incident; The names of the individual(s) alleged to have engaged in the unacceptable conduct; The details of the complaints- that is, the specifics of what was said or done to the Complainant to have triggered a complaint Summary if Incidents(Required)Please describe the impact of the behavior on the Complainant:(Required)Please describe any steps taken, to address the Complainant and the outcome of those processes:(Required)Is there any evidence to support the complaint(s)? (emails, conversations, witnesses etc.). Attach additional documents if necessary.(Required)Do you have a recommendation for a solution to this complaint and if so, what is it?(Required)Witness #1 Name(Required)Witness #1 Contact informationWitness #2 Name(Required)Witness #2 Contact informationAre you open to meditation or alternate dispute resolutions to find a way forward?(Required) Yes No Would you prefer to remain anonymous when submitting your complaint?(Required) Yes No Completed By(Required)*By completing and signing this formal complaint form, you consent to share the complaint with the Ethics Committee. At any time during the course of an Investigation of a formal complaint, the Complainant may choose to withdraw their complaint.
